McKean 01 The Jihad Virus Read online

  PART ONE: DARK DAYS IN SEATTLE

  Chapter 1

  The day I met Dr. Peyton McKean was one of the most memorable days of my life. But the day before I met him stands out clearly too - it still rings in my memory with terrifying clarity. It’s right up there with any dark day of my tour as a medical corpsman in Bagdad.

  Although the events I experienced in Iraq and Afghanistan are engraved on my soul like an eternity spent in slow motion and I still wake up nights awash in sweat and rocked with palpitations, nevertheless, the days in question were darker still. I’m a medical reporter, a healthy twenty-seven-year-old male of average height and build and looks, with good vital signs. My tours in the Mideast left no physical scars on me, but I was not to be so lucky in the events I’m about to retell. At the outset, I wasn’t infected with any disease I knew of. But things change, and not always in good ways.

  On the first day in question, I arrived at Seattle Public Health Hospital’s Hagstrom Auditorium right on time at 10 am and took a seat in the back. It had been drizzling, and I took off my damp windbreaker and slung it over the seat next to me. I opened my chair’s writing table and settled in to wait for news.

  Hagstrom was dimly lit, the modern equivalent of a half-moon-shaped Dutch Masters dissection hall. Usually the haunt of interns, residents, and chiefs of service doing Grand Rounds or an anatomy refresher course, this morning it was a hangout for a dozen pressmen and women scattered on the descending half-rings of theater seats, plus two local TV film crews, set up on either side of the small, black-carpeted stage.

  The hospital’s Public Information e-mail on the previous day had offered a shorter-than-usual note announcing the conference’s time and place, along with the normal contact names and numbers. It had promised public health news of a “significant nature,” but hadn’t said exactly what. Despite the note’s blandness, I had decided to come and see what Seattle Pub had to offer.

  After a few minutes I took a little notepad and a pen from my coat pocket and began to doodle. It seemed Dr. Kay Erwin, the hospital’s Public Relations liaison, was late. Normally, she would walk into the glare of the TV lights exactly two minutes after the appointed hour - I had become accustomed to her routine. But she had already added ten minutes to that, and counting.

  Then Kay ducked in through a side door and went to the wooden podium with the hospital’s logo on its front. A small, lightly built, pale skinned, wedding-ringless, short-haired salt-and-pepper brunette, Kay is the head of the Epidemiology Unit and one of my favorite news sources. As always, she wore a white medical coat and a pantsuit over her thin form. Today’s suit was navy blue with a crimson and gray silk scarf tied at the neckline. I would call her “formerly beautiful.” I suppose that’s a bit cruel, so let me also admit to having an idle crush on Kay - if she were my age, I might try to ask her out. She really doesn’t look half bad for forty-eight, or thereabouts.

  Besides her tardiness, I noticed something else unusual about Kay. She had a leery look to her, a deer-in-the-headlights, spooked expression. And a bit of a scared crouch. She grasped the podium with a hand that had the jitters. I felt she might be ready to dart out the way she had come in, at the slightest provocation.

  Perhaps I was using too much imagination. But there was a taut set to her lips as she squinted past the camera lights and scanned the audience. She nodded at familiar faces, giving one reporter or another a faint crooked smile. I began to suspect something more than just news-filler was in the offing. Something was afoot that Kay herself found disturbing.

  I smelled story.

  Two men had followed Kay in. A hefty, balding gentleman in a gray business suit and gold necktie, about fifty, took a seat in the front row. After him came a blue-suited Japanese American fellow with buzz cut black hair standing straight up like a wire brush. Kay sometimes introduces colleagues to make sub-presentations, but these two men didn’t fit the mold. Her medical chums usually wore white coats or turquoise surgical scrubs. Occasionally a patient in a blue hospital bathrobe would be wheel chaired in to show off a remarkable recovery. But these guys wore standard business attire, like most of my colleagues in the press corps. I glanced at the hefty man sidelong as he settled into his chair. There was something familiar about his chubby-cheeked face. He hunkered forward, apparently ready to hang on Kay’s every word. The other guy sat beside him and spoke to him in low tones.

  Kay moved near the microphone to deliver her first line. But before she did, her face pinched up like she had caught a whiff of formalin from the autopsy room. She balked in front of the microphone for a second. Knowing she was normally cool in front of a crowd, I thought it all quite odd.

  “First of all,” she blurted. “I want to assure you there is nothing to be alarmed at.”

  My eyebrows went up at that one - quite a statement from the public health lady. Right away I wanted to raise my hand and point out all the things that caused me plenty of alarm: AIDS, West Nile virus, Polio, bird flu, tuberculosis.

  “Ladies and gentlemen,” she went on, her voice cracking. “I’ll get straight to the point. We’ve got a seriously ill patient on our isolation ward.” She paused to draw a breath. “He’s got smallpox.”

  A qualm rattled through me. Had she said smallpox? I jotted the word down, although I wasn’t likely to forget it. Kay had added a whole new entry to my list of alarms. A medieval scene flickered across my mind - pockmarked, dead bodies piled high on oxcarts. I felt a crawling sensation at the back of my neck, as if a big hairy wolf spider had run across it.

  I wasn’t the only one with the creeps. Murmurs passed among the other reporters like a spreading epidemic. Nobody had expected anything so sinister. The terse public information e-mail hadn’t even vaguely hinted at this. A minute before, the video cameras and sound booms of the two TV crews had seemed like two too many. But Kay had just reset all our thinking. Now, seasoned press people whispered like bad-mannered schoolchildren. Smallpox wasn’t something you could mention without causing a stir.

  Smallpox. I scribbled the word on my notepad and noticed I had written it twice. I was in a totally unsettled mental space.

  Kay Erwin waited until the whispered echoes of her bombshell died down. “Let me give you some details,” she said. “The patient is a fifty-five-year-old male named Harold Fenton, F-E-N-T-O-N.” She spelled the surname to avoid misprints. “Last Tuesday morning he was referred to us from a community clinic in Sumas, Washington, near the Canadian border. Mr. Fenton arrived here with symptoms including fever, congestion, and the early stages of a pustular rash that has since spread over his body. In the three days Mr. Fenton has been with us we have used a DNA test to confirm his clinician’s initial diagnosis of smallpox.

  “We notified the Centers for Disease Control in Atlanta on the first day and sent them a blood sample by special military jet transport from Boeing Field. Sumas, as you may know, is a small border-crossing town between Seattle and Vancouver, British Columbia. Mr. Fenton is a U.S. Customs inspector there. That adds a significant wrinkle to this case.”

  She paused as the scribbling and typing on laptops, including my own notepad scrawling, increased to a fever pitch.

  “The border between Canada and Washington State has been on heightened alert for terrorists ever since Ahmed Ressam, the would-be Los Angeles Airport bomber, was apprehended with explosives at Port Angeles. I just want to emphasize we’ve seen nothing that establishes a terrorist connection.”

  She paused again to let another ripple of concerned whispers die down.

  “Now, regarding Mr. Fenton. He is seriously ill, but we are working diligently on his case. No one else is ill, and we consider the disease confined at this time, along with its only victim.” She
ended the statement with a note of finality, as if she had said her piece.

  There was a brief moment of near-silence, punctuated by someone whispering into a cell phone. Then a spray of hands went up. Kay nodded in the direction of the first and most eager. Arran Fisk, a local TV reporter down front asked, “Can you tell us more about where the virus came from?”

  “Unknown at this point,” Kay replied. “Possibly an immigrant traveling across the border.”

  “An immigrant from where?”

  “Unknown.”

  She nodded toward another waving hand. Victoria Tanner, an old Seattle Times Newspaper reporter in a hot pink skirt suit asked, “How big a threat does Mr. Fenton represent?”

  “Minimal,” Kay replied. “Assuming we confined him before he spread the disease to others.” The audience was buzzing and a couple more cell phone calls went out. Kay put up her hands in a slow-down gesture. “I want to emphasize again that the situation is under control.” She looked around for nods of understanding and agreement, but she didn’t get any. “Mr. Fenton’s physician, Ronald Adams, made a quick, accurate diagnosis of smallpox and moved to contain it before there was any chance for it to spread. Dr. Adams said he had recently read a smallpox-awareness article published in a medical journal, written by the Mr. Northwest Casual, up there in the back.”

  She pointed at me with the flat of her hand. By Northwest Casual, she meant my less-than-well-heeled look: an untucked T shirt in marionberry purple, khaki cargo-pocketed pants and silver-and-Day-Glo-green jogging shoes, one of which was parked on the chair back in front of me. I took the foot off the chair and smiled self-consciously at her acknowledgement. My smallpox article had been the lead story in Clinical Practice web-magazine.

  “That article,” Kay went on, “was a refresher on the CDC’s recommended response procedures. Dr. Adams followed them and reacted quite effectively. On the same day he transferred Mr. Fenton to our isolation ward, he called Fenton’s family and close contacts at work, advising them to isolate themselves at home until they had stayed free of symptoms for three weeks. A CDC field team has since arrived to monitor their compliance and institute a ring vaccination protocol. That’s where the immediate circle of contacts receives doses of smallpox vaccine. Thanks to Dr. Adams” swift action, we have every expectation that this outbreak has been halted at its start.

  “In the intervening two days since Mr. Fenton was transferred to our facility, both the CDC and the Army’s laboratories at Fort Detrick, Maryland have confirmed the diagnosis. They also identified the strain of smallpox. It’s a familiar one, referred to as the Bangladesh strain, isolated in the mid-twentieth century when the last naturally occurring strains were analyzed. Subsequently, as most of you should know, smallpox was eradicated by worldwide vaccinations in the nineteen-eighties. More recently, concern about bioterror has led the U.S. Government to vaccinate military and health care personnel. I myself got a dose several months ago.”

  Down front, a hand went up from a reporter from the Seattle Post Intelligencer Online. Melinda Coury, a newbie of the young, female, pretty, and unmarried kind, with shoulder-length dirty blond hair and an appealing spangle of freckles across her nose, responded to Kay’s acknowledgment by asking, “For our readers’ information, could you go over the symptoms of smallpox?”

  Kay’s mouth crimped like she would rather not dwell on the subject. But she dished it up. “Smallpox starts with head-and chest-congestion like a common cold, and then progresses to a high fever accompanied by white, pussy sores that cover the victim from head to foot. Many patients die from lethal effects of the fever, but some victims recover after a month or so of incapacitation.”

  A chilling thought crept into my mind as I jotted down Kay’s description. I waved my pen to catch her eye. She nodded.

  “Most younger Americans haven’t been vaccinated against smallpox,” I said. “So quite a few of us are not immune. How big a threat are we facing? What’s the worst case?”

  Kay’s jaw tightened, letting me know this question was not on her preferred list of topics. But she knew from past encounters that I would ask tough questions and stick to them.

  “That’s a very good question.” She took a sip of water from a glass on the podium and swallowed hard. “You have your facts straight, Fin Morton. Because the vaccine causes some side effects, including rare fatalities, the U.S. stopped routine vaccinations after 1977. And as you implied, most Americans under age thirty have never received smallpox shots. So they’re naturally more susceptible than older Americans who got vaccinated as children. You’re talking approximately half the U.S. population. Is that enough to satisfy you?”

  It wasn’t.

  “What about the availability of the vaccine? If the virus gets loose in Sumas, is there enough vaccine on hand to protect everybody in the U.S.?”

  Kay raised both her hands. “As I mentioned, we already have the situation under control by isolating Mr. Fenton and vaccinating his contacts. And Sumas is a very small town in a dairy farming community. There are more cows there than people. But if additional vaccine is needed, there are stockpiles nationwide that can be rushed to the area in plenty of time.”

  “Now, just a minute,” I said, struck by a thought. “You said Mr. Fenton is fifty-five years old. That means he received the original vaccine as a child.”

  “You’re good with math, Fin,” Kay replied. She shrank behind the podium and that deer-in-the-headlights look came back. She knew it was dawning on me and the others, that the implications of Mr. Fenton’s case went on and on. Her knuckles went white where she gripped the sides of the podium, making me almost want to let up on her.

  But a story is a story.

  “So why is he sick?”

  “That’s a mystery,” she croaked. “And we’re still grappling with it. We checked Mr. Fenton’s immunization records and found he was indeed vaccinated as a child. Not only that, but as a border officer, he was entitled to a shot of new vaccine, which he got just last month. That dose should have been effective against the Bangladesh strain. However, immunity takes time to build, so we’re left wondering whether Mr. Fenton’s immunization was too late.”

  My spine began to tingle. “Or,” I said, “the virus made him sick despite his immunizations.” A thought was shaping up in my mind, a scary one. “Is it possible it’s a new strain of virus?”

  She sighed, realizing I was going to drag it all out of her. “Yes, Phineus Morton, I’ll admit that your assessment fits the facts in this case. Still, I’m surprised Mr. Fenton has such a fulminant case.”

  “Fulminant?” Melinda asked.

  “A rapidly developing course of disease,” Kay responded to Melinda, no doubt relieved to break the lock that had developed between her eyes and mine. “You would expect at least a slight protective effect from Mr. Fenton’s two vaccinations. But he is in bad shape. His fever is high and he’s comatose. That’s something we would normally expect only in a non-immunized subject. It suggests there is something different about the virus, though our preliminary tests haven’t distinguished it from the old Bangladesh strain.”

  “But if it is a new strain,” I chimed in, snapping Kay’s head my direction again, “or a mutant for which the vaccine isn’t effective, then - “

  “Let’s not go there,” Kay stated flatly. She stared at me hard, signifying I had taken the idea as far as she was willing to go. “Now, if there are no further ques - “

  My hand went up again. Kay’s eyes flashed and her head tilted, warning me. My hand stayed up. I supposed I had better delete her name from my imaginary date book. When she nodded at me, I unleashed the worst question of the batch.

  “Is the virus natural or man-made? You know, a bio-warfare agent?”

  Kay let out a short, derisive laugh. She shook her head slowly. “That is pretty far fetched, Fin. Way out there. The concept of a deliberately altered virus has crossed my mind, and my colleagues’ minds. But so far there’s not the remotest hint suggesting anyo
ne has tampered with this virus’s genes. Until we have proof otherwise, we’re going to assume this is just an isolated, anomalous case, coming from a natural source. Don’t forget, the immigrant population in Vancouver B.C. has grown dramatically over the past few years. It’s possible an infected individual brought the virus from one of the former endemic areas - Bangladesh, perhaps. Right now, nothing suggests foul play of any kind. If we thought that were the case, I would tell you so. And you can bet Fort Detrick’s Biological Warfare people would take up the matter, as would the White House, the Pentagon, the CIA, and the FBI. Everyone I just mentioned is aware of the situation and none of them has declared an emergency. They all feel we have things under control here.”

  “Amen,” whispered Cameron Phipps, a colleague sitting one row ahead of me. Sweat dotted the umber skin of his forehead. He took out a handkerchief and daubed his face.

  “Please, folks,” Kay Erwin said, raising her hands again. “Sometimes my job is a balancing act between informing the public and scaring them. I want to emphasize that this single case is not a cause for public alarm. When you report it, I hope you will use a balanced approach and avoid sensationalism. Our isolation unit here at Seattle Public Health, the Northwest Regional Infectious Disease Isolation Facility, is a wonderful, ultra-modern operation. It was funded by a consortium of Microsoft, Google, and Starbucks billionaires and several well-to-do individuals, including the gentleman seated at the front of the room, who has been waiting very patiently to speak. He has some reassuring words for you.” She pointed the flat of her hand toward the bald guy. “I’d like to introduce Dr. Stuart Holloman, President and Research Director of Seattle’s Immune Corporation. Dr. Holloman.”

  Stuart Holloman! Not a guy I should have had trouble identifying. He rose and turned toward the audience and I got a better look at him. His round, pink-cheeked face was suddenly familiar. I wondered how I hadn’t identified the most eminent biotechnology mogul in town. Perhaps it was just that I hadn’t expected such a prominent man to attend what I had thought was a routine press conference.